非球面与球面人工晶状体植入术后高阶像差及对比度视力的比较

目的:比较非球面和球面人工晶状体植入术后波前像差、裸眼远视力、最佳矫正远视力、对比度视力的差异。方法:年龄相关性白内障患者46例50眼,将其随机分成两组,球面人工晶状体组(A组)23例24眼术中植入ACR6DSE球面人工晶状体;非球面人工晶状体组(B组)23例26眼术中植入具有负球面像差Acri.Smart36A非球面人工晶状体。术后3mo,观察两组患者的裸眼视力、最佳矫正视力、暗背景(25cd/m2)和高亮背景(255cd/m2)下的对比度视力、瞳孔直径(6mm)时的球面像差、彗差和高阶像差的均方根是否存在差异。结果:两组患者术后裸眼远视力、最佳矫正远视力比较差异无统计学意义,亮背景下各对比度视力以及暗背景下100%,25%对比度视力两组比较差异无统计学意义,暗背景下5%,10%低对比度时B组视力好于A组。瞳孔直径6mm时,B组高阶像差的均方根(RMS)、球差、彗差和A组比较差异均有统计学意义,B组RMS、球差、彗差低于A组。结论:Acri.Smart36A非球面人工晶状体植入术后与ACR6DSE球面人工晶状体比较可以明显的减少患者的高阶像差,改善患者的术后暗环境下的低对比度视力。

The comparison of higher-order aberration and contrast visual after the aspheric and spherical intraocular lens implantation

AIM: To compare the difference of wavefront aberration, uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), contrast visual acuity between aspheric intraocular lens and spherical intraocular lens after implantation.

METHODS: Totally 46 patients(50 eyes)with age-related cataract were divided into 2 groups at random, one group of 23 patients(24 eyes)received ACR6D SE spherical intraocular lens(Group A), another group of 23 patients(26 eyes)received negative spherical aberration Acri.Smart 36A aspheric lens(Group B). Three months after surgery, we observed patient's UCVA, BCVA, the contrast vision of dark background(25cd/m²)and highlighted background(255cd/m²), the spherical aberration, coma and total high-order aberration RMS'(pupil's diameter was 6mm)differences between two groups.

RESULTS: The differences of UCVA and BCVA between the two groups were not significant. There was no significant difference in the contrast visual acuity of 100% and 25% between highlighted background and dark background, however, under dark background, the contrast visual acuity of 5% and 10% in Group B was better than Group A. When the pupil diameter was 6mm, root-mean-square(RMS)of higher-order aberration, spherical aberration and comatic aberration in Group A were significantly lower than Group A and difference was statistically significant.

CONCLUSION:Acri.Smart 36A aspheric intraocular lens can significantly reduce patients' wavefront aberration and improve contrast visual acuity under lower contrast of dark background when compared with ACR6D SE spherical intraocular lens.